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Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance

Background. Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data. Methods. We c...

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Autores principales: Darboe, Saffiatou, Okomo, Uduak, Muhammad, Abdul-Khalie, Ceesay, Buntung, Jallow, Mamadou, Usuf, Effua, Tweed, Sam, Akpalu, Edem, Kwambana-Adams, Brenda, Kariuki, Samuel, Antonio, Martin, Bradbury, Richard S, Forrest, Karen, de Silva, Thushan I, Lawal, Bolarinde Joseph, Nwakanma, Davis, Secka, Ousman, Roca, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761311/
https://www.ncbi.nlm.nih.gov/pubmed/31505627
http://dx.doi.org/10.1093/cid/ciz463
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author Darboe, Saffiatou
Okomo, Uduak
Muhammad, Abdul-Khalie
Ceesay, Buntung
Jallow, Mamadou
Usuf, Effua
Tweed, Sam
Akpalu, Edem
Kwambana-Adams, Brenda
Kariuki, Samuel
Antonio, Martin
Bradbury, Richard S
Forrest, Karen
de Silva, Thushan I
Lawal, Bolarinde Joseph
Nwakanma, Davis
Secka, Ousman
Roca, Anna
author_facet Darboe, Saffiatou
Okomo, Uduak
Muhammad, Abdul-Khalie
Ceesay, Buntung
Jallow, Mamadou
Usuf, Effua
Tweed, Sam
Akpalu, Edem
Kwambana-Adams, Brenda
Kariuki, Samuel
Antonio, Martin
Bradbury, Richard S
Forrest, Karen
de Silva, Thushan I
Lawal, Bolarinde Joseph
Nwakanma, Davis
Secka, Ousman
Roca, Anna
author_sort Darboe, Saffiatou
collection PubMed
description Background. Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data. Methods. We conducted a hospital-based surveillance of invasive bacterial diseases in The Gambia where blood and cerebrospinal fluid (CSF) samples of hospitalized participants were processed. Three surveillance periods were defined in relation to the introduction of pneumococcal conjugate vaccines (PCVs), before (2005- 2009), during (2010–2011) and after (2012–2015) PCV introduction. We determined the prevalences of commonly isolated bacteria and compared them between the different surveillance periods. Results. A total of 14 715 blood and 1103 CSF samples were collected over 11 years; overall, 1045 clinically significant organisms were isolated from 957 patients (972 organisms [6.6%] from blood and 73 [6.6%] from CSF). The most common blood culture isolates were Streptococcus pneumoniae (24.9%), Staphylococcus aureus (22.0%), Escherichia coli (10.9%), and nontyphoidal Salmonella (10.0%). Between the pre-PCV and post-PCV eras, the prevalence of S. pneumoniae bacteremia dropped across all age groups (from 32.4% to 16.5%; odds ratio, 0.41; 95% confidence interval, .29–.58) while S. aureus increased in prevalence, becoming the most prevalent bacteria (from 16.9% to 27.2%; 1.75; 1.26–2.44). Overall, S. pneumoniae (53.4%), Neisseria meningitidis (13.7%), and Haemophilus influenzae (12.3%) were the predominant isolates from CSF. Antimicrobial resistance to common antibiotics was low. Conclusions. Our findings demonstrate that surveillance data on the predominant pathogens associated with invasive disease is necessary to inform vaccine priorities and appropriate management of patients.
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spelling pubmed-67613112019-10-02 Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance Darboe, Saffiatou Okomo, Uduak Muhammad, Abdul-Khalie Ceesay, Buntung Jallow, Mamadou Usuf, Effua Tweed, Sam Akpalu, Edem Kwambana-Adams, Brenda Kariuki, Samuel Antonio, Martin Bradbury, Richard S Forrest, Karen de Silva, Thushan I Lawal, Bolarinde Joseph Nwakanma, Davis Secka, Ousman Roca, Anna Clin Infect Dis Supplement Articles Background. Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data. Methods. We conducted a hospital-based surveillance of invasive bacterial diseases in The Gambia where blood and cerebrospinal fluid (CSF) samples of hospitalized participants were processed. Three surveillance periods were defined in relation to the introduction of pneumococcal conjugate vaccines (PCVs), before (2005- 2009), during (2010–2011) and after (2012–2015) PCV introduction. We determined the prevalences of commonly isolated bacteria and compared them between the different surveillance periods. Results. A total of 14 715 blood and 1103 CSF samples were collected over 11 years; overall, 1045 clinically significant organisms were isolated from 957 patients (972 organisms [6.6%] from blood and 73 [6.6%] from CSF). The most common blood culture isolates were Streptococcus pneumoniae (24.9%), Staphylococcus aureus (22.0%), Escherichia coli (10.9%), and nontyphoidal Salmonella (10.0%). Between the pre-PCV and post-PCV eras, the prevalence of S. pneumoniae bacteremia dropped across all age groups (from 32.4% to 16.5%; odds ratio, 0.41; 95% confidence interval, .29–.58) while S. aureus increased in prevalence, becoming the most prevalent bacteria (from 16.9% to 27.2%; 1.75; 1.26–2.44). Overall, S. pneumoniae (53.4%), Neisseria meningitidis (13.7%), and Haemophilus influenzae (12.3%) were the predominant isolates from CSF. Antimicrobial resistance to common antibiotics was low. Conclusions. Our findings demonstrate that surveillance data on the predominant pathogens associated with invasive disease is necessary to inform vaccine priorities and appropriate management of patients. Oxford University Press 2019-09-15 2019-08-30 /pmc/articles/PMC6761311/ /pubmed/31505627 http://dx.doi.org/10.1093/cid/ciz463 Text en © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Supplement Articles
Darboe, Saffiatou
Okomo, Uduak
Muhammad, Abdul-Khalie
Ceesay, Buntung
Jallow, Mamadou
Usuf, Effua
Tweed, Sam
Akpalu, Edem
Kwambana-Adams, Brenda
Kariuki, Samuel
Antonio, Martin
Bradbury, Richard S
Forrest, Karen
de Silva, Thushan I
Lawal, Bolarinde Joseph
Nwakanma, Davis
Secka, Ousman
Roca, Anna
Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance
title Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance
title_full Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance
title_fullStr Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance
title_full_unstemmed Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance
title_short Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance
title_sort community-acquired invasive bacterial disease in urban gambia, 2005–2015: a hospital-based surveillance
topic Supplement Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761311/
https://www.ncbi.nlm.nih.gov/pubmed/31505627
http://dx.doi.org/10.1093/cid/ciz463
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